Telehealth Making Sense of Brain Tumour (TeleMAST): A practical guide for therapists

Written by Ea Stewart and Tamara Ownsworth
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Individuals with brain tumour and their family members can experience considerable distress associated with the diagnosis, an uncertain prognosis and complex neurological and functional impairments. The psychological support needs of people with brain tumour are often overlooked and there is a lack of brain tumour-specific psychological therapy resources.

This therapist manual is suitable for use with adults with primary brain tumour, including benign, low-grade glioma and high-grade glioma subtypes. The manual provides detailed information on techniques for assisting people with brain tumours covering psycho-education, psychological needs and neuropsychological rehabilitation. It uses empirically established techniques including Cognitive-Behavioural Therapy, Acceptance and Commitment Therapy and Interpersonal Therapy.

The MSoBT programme is comprised of both core and modularised components, with the latter tailored to people’s goals and life situation.Using the manual, therapists are supported to tailor the therapy program and to support family members through couple and/or family support sessions. The therapist manual contains the following sections:

• Conceptual and empirical basis for the MSoBT and tips for using the therapist manual
• Information about the brain and brain tumour
• Introducing psychological therapy to clients
• Exploring the clients’ journey, information gathering and goal setting
• Neuropsychological modules
• Psychotherapy modules
• Case vignettes
• Finalising the program
  

A combination of individual and couple/family therapy sessions may be conducted to provide separate time, as well as time together with the therapist to develop a shared perspective and strategies for managing the effects of brain tumour. Common goals may include:

• Understanding and managing the effects of brain tumour;
• Coping with low mood, anxiety, stress and existential issues;
• Improving occupational functioning (e.g., work, parenting, and social activities);
• Addressing fears /concerns of family members;
• Developing a family care plan; and
• Improving relationship functioning.
  

The therapist manual does not draw upon one particular therapeutic orientation, but rather a combination of approaches that are considered the best fit for individual clients based on their presenting issues and background. This integration of techniques reflects the person-centred and goal-directed approach the authors believe is both effective for and valued by people with brain tumour and their family members.

The benefits of the MAST program have been endorsed by international palliative care guidelines, with two RCTs (Ownsworth et al., 2015; Ownsworth et al., 2023) supporting the efficacy of the program for improving mental health and quality of life. The program has also been found to be cost-effective for the Australian healthcare system (Gordon et al., 2024).

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